Make sure to find out if the home has certified nurses and trained support staff. Photo:

Whether we like it or not, there will come a time when we have to seriously consider where we see ourselves living 20 years after retirement. Given a choice, most of us senior citizens would prefer to age in place, that is, age at home in familiar surroundings.

Much as we may desire this, it may not be in our best interest. There will come a day when we find ourselves living alone. We may be fit and enjoying good health in our retirement years.

But all it takes is a fall to render us helpless, unable to get up and call for assistance. Climbing the ladder to change a bulb or reach for a jar on the top shelf may result in a mishap that sees us ending up with a broken hip and in a wheelchair.

As for adult children, they worry about their elderly parent being alone at home. They dread getting a call informing them something dreadful has happened to dear mom or dad. What if Dad suddenly has a stroke? There’s no one at home to call for an ambulance. What if Mum who has Alzheimer’s wanders out and can’t remember the way home? Worse, what if Dad experiences a cardiac arrest, and his body remains undiscovered till a week later?

Such cases have been reported in the media. We need to seriously consider the likelihood of moving to an aged care facility at some point in our later years. Living with our adult children may not be an option available to us. They may have settled overseas or are working in another city. Even when there is room in their home, the elderly parent may not want to move in and lose their freedom and independence.

There could be many reasons why the number of Home Alone elderly has risen in recent years. Only a small percent is due to a lack of filial piety. It’s best to be prepared for that eventuality and start checking out retirement homes and assisted living facilities, rather than wait for an emergency to happen and we end up leaving that choice out of our hands.

At least come up with a shortlist and share it with our children.

A nursing home with a garden scores a plus point. Residents can enjoy the outdoor sunlight and fresh air, and engage in some exercise, or in gardening.

Let’s start with private nursing homes which have been mushrooming in recent years in response to Malaysia’s growing ageing population. Operating an aged care facility, whether a nursing home or a daycare centre, has become a thriving business. Private nursing homes are a common sight in residential neighbourhoods.

Most are housed in converted bungalows or former service apartments rather than as purpose-built facilities. Nearly all have attractive websites promising quiet surroundings, daily activities and tender loving care.

Don’t be taken in by the marketing hype. The fees depend largely on the level of care required, and the services and facilities offered. Be prepared to cough up between RM3,000 to RM8,000 a month.

What do the fees cover besides meals? Laundry? Diapers? Medication? Personal toiletries? Personal grooming-haircuts, manicure, pedicure? Are there regular triage checks? The high-end ones offer a resort lifestyle, complete with swimming pool, gym, karaoke, ensuite rooms. In short, it’s akin to living in a five-star hotel, so be prepared to pay five-star fees. For the majority, even at RM3,000, most adult children can ill afford it, given their many financial commitments. With longer life expectancy, the sandwich generation of adult children has now expanded to include retirees who are carers for their elderly parent aged 90+.

With no income, limited savings, and their own declining health, these retirees struggle to look after their aged parents.

Here are some questions as a guide

1. What is your first impression of the facility? Clean? Well-ventilated and well-lit? Elder-friendly furniture and fixtures? Quiet surroundings? Safe and comfortable environment? Any greenery? If it’s a double-storey building, look for a fire escape outside. If the home looks uninviting from the outside, there really is no point ringing the doorbell. It would be a total waste of your time.

2. Is the home licensed? This serves as a good guide as certain conditions such as fire safety need to be fulfilled before a license can be issued. Ask whether there is a proper admission procedure. Is there a management team to oversee running of the home? Homes that are operated by one or two individuals with little relevant experience or qualifications are likely to be unlicensed.

3. Are the nurses certified and the support staff trained? Remember, you will be leaving your loved one in their care 24/7. Do they treat the residents with respect and patience? Is there a resident doctor or physiotherapist? Do the staff look overworked or unfriendly? Are they mostly foreigners or locals? Are they able to communicate with the elderly to understand their needs? What are the provisions for emergencies? Do the staff keep you informed about your loved one when you are away? What is the staff to residents ratio?

4. Are there meals planned with the dietary needs of the elderly in mind? Is the menu changed daily? Is there a weekly programme of activities such as morning exercises, art and music sessions? Or are the residents left to themselves to watch TV most of the time? Does the home arrange for outings or for volunteer groups to visit regularly and interact with the residents? Do the elderly residents look neglected and bored?

Ask around for recommendations from friends who have a family member in a nursing home. Do some research online to back up a recommendation. Then contact the home to arrange for a visit.

If they say you are welcome to drop by anytime, it is a good sign that they are prepared to be ‘inspected’ at your convenience, and not theirs. Remember to ask the right questions during the visit, and make a mental note of everything you see, both good and not so good.

I hope this article gives you an idea of what to look for in a good retirement home or nursing home for yourself or for an elderly. You will be surprised how many homes you will strike out from your list before you finally find one that could be the answer to your prayers.

This article by Lily Fu was first published in The Star (Mon, 02 Oct 2023) in the Grey Matters column. The online edition can be accessed at this link:

(Lily Fu is a gerontologist who advocates for seniors. She is founder of SeniorsAloud, an online platform for seniors to get connected and enjoy social activities for ageing well.)


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